Premier Wynne promised during the election campaign she would increase the hourly wage for personal support workers, improve access to primary care physicians, expand home care and improve access to dental services for children in low-income families.

She would assist low-income families with vision care, drug coverage and mental health services. The premier said she would also eliminate service waitlists for 21,000 people with developmental disabilities.

These are worthy aims, but there are many more needs that are not on her list and the list keeps growing.

Although 90 per cent of Canadians have indicated they would like to die at home, 70 per cent die in hospital or long-term care homes. The average debt is growing more for seniors than any other age group.

For many, their savings and pensions may not be able to finance both accommodations and a proper diet. In the next two decades, the number of centenarians will triple and the number of adults aged 85 and older will quadruple.

Understanding these realities, a number of major health reports have recommended moving primary care and prevention strategies from the backend to the forefront of the health care system; creating a national home-care program and a national drug formulary to deal with rising drug costs; and providing a catastrophic drug plan to assist Canadians needing expensive drugs.

Because successive federal and provincial governments have made deficit reduction their main priority, they did not act on these recommendations.

Ontario’s new deputy minister of health is already on record saying the province should improve health services without spending more money. Ms. Wynne said that her government would balance Ontario’s budget by 2017/18.

So, if money is the key, let's talk about it. In Ontario, 70 per cent of health care spending comes from taxes, while 30 per cent is paid by the client or by the employer.

The list of services not fully covered is long. Thirty years ago, health services consumed 25 per cent of the provincial budget. It is now 50 per cent. Contrary to the perception, Ontario is actually one of the lowest spending provincial governments when it comes to health care.

Unfortunately, Ontario’s tax receipts are also low and the deficit is rising.

To be practical, what should we, the taxpayers, pay for and how should we pay for it?

We make these types of decisions all the time in our personal lives. But governments have had great difficulty doing so because they fear our displeasure.

Recent surveys have found that Canadians would like more services without paying for them. As a consequence, we are in a muddle.

Consider the following facts.

Health Sciences North has been told to expect no increase in its funding from the Ministry of Health. HSN will have to absorb $4.5M in wage increases. Visits to the emergency department and admissions to hospital beds have been increasing. The advice from the ministry is, “Do more with less.”

Ontario now has a majority government and the opportunity to take bold steps. How about restructuring the province’s health care system, with the goal of doing the most good, the least harm, in a just and affordable manner, and doing it with compassion and in good faith?

Dr. Peter Zalan is president of the medical staff at Health Sciences North. His monthly column tackles issues in health care from a local perspective.

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